clinical assessment, 1341 clinical recognition, 1340 –1341 management, 1341 treatment goals, 1340 triage considerations, 1341 Urinary tract infection (UTI), 199 , 201 –202 , 235 , 237 , 292 , 338 , 384 , 501 t, 529 , 553 , 569 Urobilinogen, 289 Urosepsis, 503 Urticaria, 452 , 453 f, 650 –651 Urticaria pigmentosa, 465 Usher syndrome, 222 Uterine bleeding in adolescent patient, 537 –538 diagnostic approach, 540 f treatment guidelines for, 539 t Utstein Criteria, 45 V Vaginal bleeding differential diagnosis, 536 t evaluation and decision, 533 from infections, 535 in neonate, 534 in nonpregnant adolescent patient, 535 –539 precocious puberty, 535 in pregnant patient, 539 –541 early pregnancy, 540 –541 ectopic pregnancy, 541 late pregnancy, 541 in prepubertal patient, 533 –535 with shock, 541 from tumors, 535 vaginal foreign body and, 535 from vascular anomalies, 535 Vaginal cysts, 1339 Vaginal discharge, 36e